Few people think that osteoporosis is only caused by old age or menopause in women. In fact, many endocrine diseases can cause osteoporosis, including diabetes in about 10% of the population in Hong Kong. Studies have shown that about one-third of diabetic patients have osteoporosis. .
If a citizen has symptoms of osteoporosis or fractures, doctors are required to find out the cause before they can prescribe the right medicine.
Written by: Dr. Li Ka Kui, Medical Consultant, Medical Consultant and Former President of the Hong Kong Osteoporosis Society
Bone density is the best when it is 25 to 30 years old. Later, as we get older, bone loss begins; especially for women who have a sudden decrease in estrogen secretion after menopause, bone density will deteriorate significantly.
Bone density in type 1 diabetic patients is at its peak and lower than normal
In addition to hormonal changes during menopause, a variety of endocrine diseases or drugs can cause secondary osteoporosis, including type 1 and type 2 diabetes.
Type 1 diabetes is when the body’s immune system destroys islet cells, which are unable to secrete insulin normally, causing the patient to be injected with insulin for treatment.
Insufficient insulin can affect the body and bone growth.
Dr. Li Kaju said that endocrine diseases can also cause osteoporosis.
Because type 1 diabetes usually occurs in children or adolescents, people’s bone mass is still growing during this period and reaches its peak at the age of 25 to 30; however, the bone and bone density of such patients are lower than normal when they reach the peak level. "It's best to go as soon as you start the wave," which increases the risk of osteoporosis and fractures in the future.
Osteoclasts in type 2 diabetic patients grow slowly and lose fast bone
Humans have osteoblasts and osteoclasts, which cause bone proliferation and loss, respectively.
In the process of bone metabolism, part of the bone tissue is destroyed and new bone tissue is formed. The two must be balanced to maintain the stable growth of bones.
Type 2 diabetes will cause fewer osteoblasts, more active osteoclasts, and high blood sugar will produce a lot of chemicals that are not good for bone, resulting in slow bone growth and rapid loss, thus increasing the risk of osteoporosis.
Most type 2 diabetic patients are 40 or above, so osteoporosis in type 2 diabetic patients usually occurs in middle age or later.
Studies have pointed out that, overall, about one-third of diabetic people will have osteoporosis.
In addition to diabetes, thyroid disease can also cause osteoporosis.
The proper level of thyroxine in the human body is very important for bone growth and reconstruction. Some thyroid diseases can interfere with normal bone metabolism and increase the risk of osteoporosis and fractures.
For example, hyperthyroidism can lead to excessive secretion of thyroid hormones, bone destruction is greater than new bone formation, and bone loss increases.
Another endocrine disease, Cushing’s syndrome, is also closely related to osteoporosis.
Patients with Cushing’s syndrome have high levels of adrenal cortisol, which inhibits bone formation and intestinal absorption of calcium, and increases the loss of calcium from the kidneys, which increases the risk of osteoporosis.
Rheumatoid arthritis increases the risk of osteoporosis
Rheumatoid arthritis also affects bone metabolism, and men’s disease causes low male hormones, which can easily lead to osteoporosis.
One of the symptoms of bone marrow cancer is the collapse of the spine, which is very similar to the osteoporosis of ordinary postmenstrual women. Doctors should pay attention to whether the patient may have bone marrow cancer.
In addition, patients who take long-term steroid therapy, use old-fashioned thin blood needles, hormone drugs to prevent breast cancer recurrence, or some diabetes medications will increase the risk of osteoporosis.
When a patient develops symptoms of osteoporosis or fractures, seek medical advice as soon as possible to find out the cause and treat it at the root.
Patients suffering from endocrine diseases should also pay attention to whether it has caused secondary osteoporosis.
The public should maintain good health and avoid smoking and drinking to reduce the risk of osteoporosis.
People with diabetes should avoid using drugs that increase the risk of osteoporosis when permitted.
If you want to take high-dose steroid therapy, you can take osteoporosis specific drugs when necessary, and get enough calcium and vitamin D. When the disease progresses, reduce the steroid dose.
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Lam Cheng’s fracture︱Doctor: Osteoporosis is likely to cause fractures. Women who are at high risk should take more calcium. Osteoporosis can cause fractures silently. Dual-energy X-ray bone mineral density meter is the most accurate diagnosis and exercise to prevent osteoporosis. Run, lift weights, and play basketball. Improve the bone quality of different body parts
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